| National Inpatient
Acute Myocardial Infarction
objectives | resources
Medicare Quality Improvement Project
Cardiovascular disease is America’s biggest killer. Every
minute an American dies of coronary heart disease. Each year, approximately
1.1 million people experience an acute myocardial infarction (AMI)
or heart attack. Almost two-thirds of heart attack patients do not
make a complete recovery, and people who survive the acute phase
have a chance of related illness and death that is 2 to 9 times
higher than that of the general population. One third dies during
the acute phase. Older Americans bear the brunt of this medical
burden. Over 80 percent of all heart attack-related deaths occur
in individuals age 65 or older.
Heart disease is the leading cause of hospitalization among persons
age 65 or older. In 1996, AMI accounted for 394,850 hospitalizations
among Medicare beneficiaries, or about 12 hospitalizations for every
1,000 enrollees. The payments to hospitals for these episodes totaled
over $3.6 billion, or about $9,780 per discharge.
Main Objective
To decrease the morbidity and mortality associated with AMI in Medicare
beneficiaries.
Process Objectives
To increase the use of the following care processes for patients
hospitalized with AMI:
- Administration of aspirin within 24 hours before
or after hospital arrival
- Administration of beta blocker within 24 hours
of hospital arrival
- Timely initiation of reperfusion therapy
- (either thrombolytic agent or percutaneous coronary
intervention)
- Aspirin prescribed at discharge
- Beta blocker prescribed at discharge
- Angiotensin converting enzyme (ACE) inhibitor
prescribed at discharge if left ventricular ejection fraction
(LVEF) is impaired
- Smoking cessation counseling during hospitalization
The project also includes select related measures
as well as test measures for future quality improvement activities.
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Links & Resources
HSAG Project Contact
Suzanne R. Anders, RN, BSBA, CPHQ
Clinical Quality Specialist
Telephone: (520) 661-9370
Telephone: (602) 665-6171
E Mail:sanders@azqio.sdps.org
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